Health Impact

Assessment for
Development
Projects
Health Promotion Bureau
Department of Health
Health is primarily determined by factors outside
the health sector
Check and balance mechanisms will be integral to ensuring
safe, equitable, and health-promoting developments

In an ideal scenario:
Policies, Programs, and Projects routinely incorporated
during proposal phase

Social Determinants of Health

Health Outcomes
Example: Upgrade Structures for Permanent Protected Bike Lanes

Use of concrete barriers to designate *HIA

permanent protected bike lanes

physical activity, cars on the road

= air quality, “protected
infrastructure” for road sharing =
confidence & sense of safety for
cyclists

risk for obesity, risk for respiratory

disease, risk for injuries & premature
deaths, health care costs
Health Impact Assessment (HIA) (1)

A means of assessing the

health impacts of policies,
programs, and projects in
diverse economic sectors
before, during, and after
implementation. (UHC Act
IRR)
Health Impact Assessment (HIA) (2)

It is a combination of procedures,
methods, and tools by which a policy,
program, or project is evaluated in
order to provide practical and
alternative recommendations to
increase positive health effects and
minimize negative health effects,
while attaining the development
objectives of the proposals that are
approved.
Process Flow in Conducting HIA
Purpose

Screening Determine of HIA is needed/required

Select significant issues to be analyzed (guided by the

Scoping SDH framework) and identify vulnerable groups

Appraisal Synthesize and triangulate evidence to determine

health impacts and its distribution

Reporting Develop and propose actionable, evidence-based

recommendations
Monitoring and Track the implementation of the approved proposal
Evaluation vis-a-vis the recommendations
(Example)Conducting HIA: Permanent Protected Bike Lanes

Screening Required to undergo HIA (as per UHC Act)

Do concrete barriers enable: (1) Protected infrastructure for
Scoping road sharing; (2) Ensure sense of security for cyclists and
pedestrians; (3) Increased bike use and cycling trends

Appraisal Synthesize and triangulate evidence on concrete barriers

and incidence of: accidents and injuries, increase in
physically active Filipinos, health care savings

Reporting Option 1: raised curb barrier; Option 2: plant box

concrete barrier; Option 3: full concrete barrier
Monitoring and % of localities with the upgraded permanent bike lanes; cycling
Evaluation traffic density in permanent protected bike lanes vs temporary
bike lanes; incidence of reported accidents & injuries
Leveraging UHC and Health Promotion to (re)introduce
and institutionalize HIA in the Philippines’ health sector

Health Impact Assessment

can be leveraged to ensure
‘advantageous’ SDH
through safe, health-
promoting, and equitable
developments
Establish Proof of Concept: HIA Test Case (Philippines)
Project impacts do not occur in a vacuum and cannot be defined by risks from one
sector only

Employment/ Livelihood: Access to Clean Water: Education:

● Altered productivity of ● Competing demand for Increased incidence of
Housing Sector: local agricultural water rashes & asthma
Inadequate workers and fisher ● Additional household among students
resettlement/ folks expense due to cost of resulting in school
relocation plan ● Reduced purchasing drinking water absence
power due to lower ● Poor sleep quality for
income residents and reduced
QoL
HIA Mandate Non-Negotiables (UHC Act)

1. Assessments anchored on the Social

Determinants of Health
2. Strong community participation
3. Maximizes community and technical
knowledge systems
4. Policy-relevant findings and
recommendations are elevated to
decision-makers to initiate policy
reforms
Legal Basis (1/2)
UHC Act
Implementing Rules and Regulations

Section 33. HIA shall be required for policies,

programs, and projects that are crucial in
attaining better health outcomes or may have an
impact on the health sector (§33, RA 11223)

Section 33.1. The DOH, in coordination with the NEDA,

DILG, DENR, relevant LGU, and other executive agencies,
shall ensure that Health Impact Assessment is conducted,
public health mitigation and management plans are
implemented for all development initiatives, and members
of potentially affected communities are well-represented
in the process.
Legal Basis (2/2)
UHC Act
Implementing Rules and Regulations

Section 33.2 For development initiatives classified as

projects, the DOH shall convene a review committee, and
issue health impact clearance for projects upon positive
recommendation of the committee.

Section 33.3. For development initiatives classified as

policies and programs, findings from the assessment
and recommendations shall be appraised by relevant
DOH offices and formally endorsed to appropriate
national government agencies.
Implementing Guidelines and Foundational Policies
DEVELOPMENT PROJECTS
DOH-DILG Joint Administrative Order No.
For development initiatives classified as projects, 2021-0001: Guidelines on the
the DOH shall convene a review committee, and Operationalization of Health Impact
issue health impact clearance for projects upon Assessment Review Process for
positive recommendation of the committee (UHC Development Projects
IRR 33.2).

POLICIES AND PROGRAMS

For development initiatives classified as policies DOH Administrative Order 2021-0064:

and programs, findings from the assessment and
Guidelines on the Operationalization of Health
recommendations shall be appraised by relevant
DOH offices and formally endorsed to Impact Assessment for Policies and Programs
appropriate national government agencies
(UHC IRR 33.3).
 Delineation of HIA with EIA and EHIA
Health Impact Assessment Environmental Impact Assessment

Legal Basis RA 11223: UHC Act PD 1586

Health Impact Clearance Environmental Compliance

Certification Issued
Certification Certificate

DOH - Health Promotion Bureau DENR - Environmental Management

Lead Office
(PPSRD) Bureau

Effects on population health

Lens of Assessment through Social Determinants Effects on biophysical
and Review (which includes Environmental environment
Determinants)

Implementation
Already operationalized Already operationalized
Status
 HIA is not…
Unit of Analysis

HTA Evaluation of the properties, effects, and/or impacts of health technology

(DOST) such as drugs, medical devices, and medical procedures.

Surveillance Activities Ascertains the association between a single risk factor and a single health
(Epidemiology Bureau) outcome.

Health Program
Assess the efficacy of health programs and to ascertain if it was able to
Evaluation
deliver the intended effects of the program.
(other DOH Offices)

Health Risk Assessment Predict the effects of exposure to chemical contaminants to human health
Development Projects:
Health Impact
Assessment
Review Process
Health Promotion Bureau
Department of Health
Implementing Guidelines and Foundational Policies
DEVELOPMENT PROJECTS
DOH-DILG Joint Administrative Order No.
For development initiatives classified as projects, 2021-0001: Guidelines on the
the DOH shall convene a review committee, and Operationalization of Health Impact
issue health impact clearance for projects upon Assessment Review Process for
positive recommendation of the committee (UHC Development Projects
IRR 33.2).

POLICIES AND PROGRAMS

For development initiatives classified as policies DOH Administrative Order 2021-0064:

and programs, findings from the assessment and
Guidelines on the Operationalization of Health
recommendations shall be appraised by relevant
DOH offices and formally endorsed to Impact Assessment for Policies and Programs
appropriate national government agencies
(UHC IRR 33.3).
Republic Act No. 11223 or the UHC Act (2/5)

Department of Health - Department of Interior and Local

Government Joint Administrative Order No. 2021-0001:
Guidelines on the Operationalization of the Health Impact
Assessment Review Process for Development Projects

Provided operational framework and implementing

guidelines in conducting the HIA Review Process and the
issuance of the Health Impact Clearance Certificate for
Development Projects

Signed last January 23, 2021

Published in Philippine Star last March 3, 2021

What are development projects?

The UHC Act and the DOH-DILG JAO 2021-

0001 defined development projects as…

“All proposed and existing physical or

infrastructure undertakings, initiated by either
public or private proponents to achieve any
specific development or economic objective.”
 Summary of Key Provisions: DOH-DILG JAO on HIA for
Development Projects
Who does what Manage Process: DOH Health Promotion Bureau, Centers for Health Development*
Commission HIA: Proponent (Public or Private)
Conduct HIA studies: Preparers
Assess & Recommend: Review Committee (Experts, relevant NGAs, CSOs, LGUs), Centers
for Health Development*
Issue Certificate: Secretary of Health, Regional Director - CHD*

Who finances Proponents: Cost of conducting HIA, and implementing mitigation measures
DOH: Cost of maintaining the HIA Review Process

Which projects are ● Proposed project site is in a Health Sensitive Area

included OR
● Projects categorized as Health Sensitive, per DENR’s [EMB Memorandum Circular
No. 2014-005]

Which projects are ● The project does not fall under the categories of projects in health sensitive areas
exempted and health sensitive projects
● Total cost of the project will not exceed the cost threshold of Php 2.5 billion.
● Proponents cannot self exempt projects
Stakeholders

Centers for Health

Project Proponents DOH (HPB) Development
Commission the conduct Manages the HIA Conduct M&E of
of HIA Review Process development projects

HIA Preparers HIA Review Committee P/CWHS & LHBs

Conduct the HIA and Conduct the review and Provide community
develop the reports appraisal of HIA Reports knowledge and inputs
HIA Review Process: Inclusion Criteria

PROJECTS IN HEALTH SENSITIVE AREAS HEALTH SENSITIVE

Areas developed for PROJECTS
Disease-endemic areas
tourism purposes
Determination of
projects as health
Areas with limited local Areas of indigenous and sensitive shall be based
health system capacity ancestral domains on the Department of
Environment and
Areas vulnerable to Areas designated as Natural Resources’
natural or climate industrial (DENR) Categories of
occurrences town/zone/site ‘Environmentally Critical
Projects’ (EMB
Areas where local Areas whose land is
Memorandum Circular
communities derive their converted for housing and
No. 005 s. 2014).
livelihood and basic needs resettlement purposes
Procedures

HIA Review Process Objective

Screening Review To identify whether the development project will be required to

conduct an HIA and submit an HIA Report to the DOH

Scoping Review To establish the scope of the HIA to be conducted and finalize the
HIA Terms of Reference

Convene HIA RevComm To appraise HIA Reports and issue the HICC

Monitoring and To ensure compliance of Project Proponents to the conditionalities

Evaluation stated in the HICC

The HIA Review Process shall abide by the Anti-Red Tape Authority (ARTA)
The Review Process shall be completed within 20 days employing a stop-clock
mechanism for steps and procedures not under the purview and beyond the control of
DOH
HIA Process vis-a-vis HIA Review Process
Project Proponent/ HIA DOH/ DILG/ HIA Review
Preparer Committee

Screening Screening Review

Scoping Scoping Review

Appraisal Review of HIA

Reporting Issuance of HICC

Monitoring & Monitoring &

Evaluation Evaluation
 HIA Process vis-a-vis HIA Review Process
HIA HIA REVIEW

Screening
Screening

Proponent HIA RevCom

Review
Submission of Screening Form RevCom screens projects
and Draft Scoping Guide based on inclusion criteria

If APPROVED, proceed to
Scoping

Scoping Activities under

SCOPING
 HIA Process vis-a-vis HIA Review Process
HIA HIA REVIEW

Proponent HIA RevCom

Scoping Review
Community Profiling
Scoping

Community and Technical Scoping

Scoping Report Ad Referendum
Review
Development of Health Impact
Pathway Design

HIA Terms
of
Reference
Appraisal

If APPROVED,
Proponent can now
conduct HIA
(APPRAISAL)
 HIA Process vis-a-vis HIA Review Process
HIA HIA REVIEW

Proponent HIA RevCom

Data Gathering Review of HIA

Appraisal
Appraisal

Report and
HIA Report PHMMP
Evidence Synthesis of
Potential Impacts
Revisions on HIA
Characterization of Potential PHMMP Report and
Impacts PHMMP

If APPROVED, HIA RevCom

the HICC
Issuing
prepares issuance of HICC,
Project Implementation with sworn adherence by
proponent to HICC
conditions
 HIA Process vis-a-vis HIA Review Process
HIA HIA REVIEW

Proponent HIA RevCom

Conduct of Self-Monitoring Creation of Multi-sectoral

Monitoring &
Evaluation

Evaluation
Monitorin

Monitoring Team
g&

Conduct of Monitoring and

Evaluation Activities

Revision of PHMMP Development of M&E

(if needed) Report

Review of RevCom
HIA Review Process for Exempted Projects
Project Proponent/ HIA DOH/ DILG/ HIA Review
Preparer Committee

Screening Screening Review

Development of
Review of PHMMP
PHMMP

Monitoring & Monitoring &

Evaluation Evaluation
 HIA Review Process for Exempted Projects
HIA HIA REVIEW

Proponent HIA RevCom

Submission of Screening Form

Screening
Screening

RevCom screens projects

Review
and Draft Scoping Guide based on inclusion criteria

If EXEMPTED, proceed to
Development of Draft TOR and
Development of PHMMP
 HIA Review Process for Exempted Projects
HIA HIA REVIEW

Proponent HIA RevCom

Community Profiling

Review of
PHMMP
Development of

Community and Technical

PHMMP

PHMMP Ad Referendum
Scoping
Review
Development of Health Impact
Pathway Design

If APPROVED, HIA
RevCom issues COE
 HIA Review Process for Exempted Projects
HIA HIA REVIEW

Proponent HIA RevCom

Conduct of Self-Monitoring Creation of Multi-sectoral

Monitoring &
Evaluation

Evaluation
Monitorin

Monitoring Team
g&

Conduct of Monitoring and

Evaluation Activities

Revision of PHMMP Development of M&E

(if needed) Report

Review of RevCom
Roles and Responsibilities
Health Promotion Bureau
● Provide overall management and technical oversight to the HIA Review Process;
● Lead the coordination with relevant national government agencies related to the
conduct of the HIA Review Process; and
● Facilitate the selection of HIA Review Committee Members from an expert pool
through official nominations from the NGAs, academic institutions, and from the general
public.

The Centers for Health Development

● Lead the monitoring of compliance of Project Proponents with the conditions and
agreements in the HICC Certifications for projects implemented in their jurisdiction;
● Lead the HIA Review Process for region-specific projects upon attainment of system
maturity; and
● Establish a grievance redress mechanism to address reports and complaints from
stakeholders on development projects
Roles and Responsibilities
The Local Government Units shall require the submission of an HICC in acquiring development,
business, and building permits for projects to be implemented under their jurisdiction. They shall
coordinate with and provide assistance, when necessary, to the CHDs in monitoring compliance
of Project Proponents with the conditions and agreements stipulated in the HICC.

The Department of Interior and Local Government

● Ensure compliance of LGUs with the provisions stated in this Order.
● Establish a grievance redress mechanism at the LGUs to address reports and complaints
from stakeholders on development projects

Project Proponents:
● Commission the conduct of a Health Impact Assessment or development of PHMMP
(for exempted projects);
● Abide by the protocols and processes of the HIA Review Process for Development
Projects set by the DOH & DILG; and
● Implement the PHMMP.
Roles and Responsibilities in the HIA Review Process
HIA Review Process Stage
HIA Review
Screening Scoping Issuance of Monitoring
Stakeholder Committee
Review Review HICC/COE and Evaluation
Meetings
DOH - Health
Promotion ✓ ✓ ✓ ✓
Bureau
✓ ✓
CHDs ✓
* * * *
P/CWHS ✓ ✓
Ensure that a physical copy of signed HICC/COE is present in the submitted
LGU
paperworks before issuing necessary permits.
Ensure compliance of LGUs in the provisions stipulated in the DOH-DILG Joint
DILG
Issuances

*Will be independently carried out by CHDs upon attainment of system maturity.

Ensuring optimum operation of HIA processes for development projects, policies, and programs at
the national, regional, and local levels by 2030
GOVERNANCE DEMAND AND INFO STANDARDS AND
CAPACITY BUILDING
STRUCTURE DISSEMINATION SYSTEMS

Routine function of the Develop a pool of HIA Increase and sustain Establish system maturity
HIA Review Process for practitioners, reviewers, demand for HIA and at the regional, local, and
development projects, and implementers improve information community level
policies, and programs dissemination
 DOH-DILG Joint Administrative Order No. 2021-0001
Guidelines on the Operationalization of the HIA Review Process for Development Projects
Governance
Structure

The Department of Health, in coordination with the Department

Capacity
Building

of Interior and Local Government, shall management and provide

technical oversight of the HIA Process and HIA Review Process for
development projects.
Demand and
Info Dissem

The DOH-DILG JAO provides the operational guidelines, structure,

and other implementation guidelines in conducting HIA and the
and System
Standards

HIA Review Process for development projects.

 HIA Review Committee for Development Projects
Governance
Structure

The HIA Review Committee composed of external subject

matter experts from various fields of expertise shall be
Capacity
Building

convened to provide technical input and support to the DOH

in assessing and reviewing HIA Reports and other relevant
documents. (DOH-DILG JAO 2021-0001)
Demand and
Info Dissem

○ Creation of the Ad Hoc HIA Review Committee by

virtue of DPO 2023-7066
and System
Standards

○ Call for Nomination for Expansion of the HIA Review

Committee to be issued
Department Personnel Order No. 2023-7066 officially
constituting the HIA Review Committee
 HIA Review Committee for Development Projects

3
Governance
Structure
Capacity
Building
Demand and
Info Dissem

Development
Projects under
and System
Standards

review

Department Personnel Order No. 2023-7066 officially Members of the HIA Review Committee for Development
constituting the HIA Review Committee Project conducts an online committee meeting on January 5,
2023
 ● Online Orientation on HIA
● The Health Promotion Bureau, in
○ February 2022
collaboration with development partners
Governance
Structure

○ September - December 2022

such as the World Health Organization ○ November - December 2023
and the Asian Development Bank and
academic partners, shall develop free, Training-Workshop on the Conduct of
Capacity
Building

●
accessible, and sustainable training HIA for Development Projects
programs and other capacity building ○ November 2022
activities towards the establishment of a ○ December 2022
Demand and
Info Dissem

cadre of local HIA preparers and

reviewers. ● Training-Workshop on the Evaluation of
HIA Reports and PHMMPs
and System
Standards

● HPB shall collaborate with other learning ○ April 2024

institutions to integrate HIA in degree- ○ June - July 2024
granting programs and courses.
Governance Capacity Demand and Standards
Structure Building Info Dissem and System
 ● DOH Academy Course on Health Impact Assessment
Governance
Structure

○ Offline training modules to be made available in the DOH Academy and Local
Government Academy
○ Target Date: Q4, 2024
Capacity
Building

● Short Course on Conduct of Health Impact Assessment for Development Projects

○ 5-day hybrid training
Demand and
Info Dissem

○ Target Date: Q4, 2024 - Q1 2025

● Evaluation of HIA Report and Public Health Management and Mitigation Plan
and System
Standards

○ 3-day training
○ For nationwide rollout with ADB
 ● The Health Promotion Bureau shall ensure that all project
Governance
Structure

proponents, national government agencies, community

members, and all relevant stakeholders are well-informed
and guided on the HIA Processes, including any emerging
developments in process recalibration.
Capacity
Building

● A Social and Behavior Change Communication Plan shall

be developed to ensure the development and
Demand and
Info Dissem

implementation of appropriate above-the-line and below-

the-line communication packages.
and System

A joint policy issuance with template ordinance shall be

Standards

●
developed with DILG to provide localized interventions and
guidance to P/CWHS and Local Chief Executives.
Governance
Structure

● The Health Promotion Bureau developed

standard operating procedure and process
guide manuals to guide HIA implementers,
Capacity
Building

reviewers, preparers, and community

members and the general public in
Demand and
Info Dissem

navigating the HIA Review Process. A

methods guide on the conduct of HIA is
also currently being revised.
and System
Standards
 Issuance of Standards and Guidelines
Governance
Structure

The HPB issued the three (3) guidance documents:

1. Standard Operating Procedure Manual for the HIA Review Process

for Development Projects - a comprehensive guidelines in
Capacity
Building

operationalizing the review process by outlining internal processes

and protocols, providing evaluation tools and metrics, and
developing forms and templates for consumption of HIA reviewers
Demand and
Info Dissem

and implementers at the national, regional, and local levels

2. HIA Review Process for Development Projects: A Process Guide
for the Filipino People - abridged version of the HIA Review Process
and the conduct of HIA to guide Project Proponents, HIA Preparers
and System
Standards

and the general public in navigating HIA for the issuance of

certificates

3. Methods Guide on the Conduct of HIA for Development Projects -

the step-by-step process as well as tools and templates used in
conducting HIA for development projects as envisioned by the UHC
Act
 ● A Health Impact Assessment Application System is currently being developed by the
DOH to streamline and promote ease of submission and application for HIA certificates.
Governance
Structure
Capacity
Building
Demand and
Info Dissem
and System
Standards
HIA is not meant to block developments, but instead
ensure appropriate checks are in place so that
developments are not made at the expense of the
health and well-being of the people.
 Health Impact Assessment is a
support mechanism to protect
UHC gains, by ensuring that
people don’t return to
conditions that make them sick.
THANK
YOU!